Estimation of bladder volume from afferent neural activity

Abstract

Refractive urinary dysfunction in individuals suffering from neurogenic bladder syndrome can be treated with implanted neurostimulators that restore, to some degree, the control of the urinary bladder. A sensor capable of relaying feedback from bladder activity to the implanted neurostimulator is required to implement a closed-loop system to improve overall implant efficacy and minimize deleterious effects to neural tissue caused by continuous electrical stimulation. In this paper, we present a method that allows real-time estimation of bladder volume from the primary afferent activity of bladder mechanoreceptors. Our method was validated with data acquired from anesthetized rats in acute experiments. It was possible to qualitatively estimate three states of bladder fullness in 100% of trials when the recorded afferent activity exhibited a Spearman's correlation coefficient of 0.6 or better. Furthermore, we could quantitatively estimate bladder volume, and also its pressure, using timeframes of properly chosen duration. The mean volume estimation error was 5.8 ±3.1%. Our results also demonstrate that it is possible to quantify both phasic and tonic bladder responses during slow filling and isovolumetric measurements, respectively.